对比分析TCRM与LM治疗子宫黏膜下肌瘤的有效性及安全性

To compare the efficacy and safety of TCRM and LM in the treatment of uterine submucous myoma

目的 探究宫腔镜下电切术(TCRM)与腹腔镜子宫肌瘤剔除术(LM)治疗子宫黏膜下肌瘤的有效性及安全性.方法 按随机数字表法将2018年7月-2023年1月江西省九江市濂溪区人民医院收治的80例子宫黏膜下肌瘤患者分为两组,每组各40例.对照组采用LM治疗,观察组采用TCRM治疗.比较两组手术相关指标、子宫内膜容受性、微炎症状态[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、并发症.结果 相较于对照组,观察组术后排气及住院时间短(P<0.05).两组术后1个月子宫内膜血流阻力指数、血流搏动指数均降低,子宫内膜厚度增加,且观察组上述指标优于对照组(P<0.05);两组术后1d血清TNF-α、IL-6、hs-CRP均升高,但观察组低于对照组(P<0.05).两组并发症总发生率比较,差异无统计学意义(P>0.05).结论 TCRM治疗子宫黏膜下肌瘤可改善患者的子宫内膜容受性,减轻其微炎症状态,且并发症较少,利于患者康复.

Objective To investigate the efficacy and safety of hysteroscopic electrohysterectomy(TCRM)and laparoscopic myomectomy(LM)in the treatment of uterine submucous myoma.Methods A total of 80 patients with submucous myoma of uterus admitted to Lianxi District People's Hospital of Jiujiang City,Jiangxi Province from July 2018 to January 2023 were divided into two groups with 40 cases in each group by random number table method.The control group was treated with LM and the observation group was treated with TCRM.Surgery-related indexes,endometrial receptivity,microinflammatory status[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]and complications were compared between the two groups.Results Compared with the control group,the postoperative exhaust and hospital stay in the observation group were shorter(P<0.05).Endometrial blood flow resistance index and blood flow pulsation index were decreased and endometrial thickness was increased in both groups one month after surgery,and the above indexes in observation group were better than those in control group(P<0.05).Serum TNF-α,IL-6 and hs-CRP levels in both groups were increased 1 day after surgery,but the observation group was lower than the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion TCRM in the treatment of submucous fibroids of uterus can improve the endometrial tolerance,reduce the microinflammatory state,and have fewer complications,which is conducive to the rehabilitation of patients.